ACTION ALERT: Protect Medicaid Reimbursement for Case Management

Last month, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (CMS-2237-IFC). This regulation will drastically cut Medicaid funding for case management services that currently assist Medicaid-eligible children and adults with disabilities to access essential long term supports, social, medical, educational and other services.

We are opposed to a number of the provisions of this rule, particularly the following new restrictions:

Transition case management services, which are critical to assisting individuals in moving from institutions to the community, are limited to a maximum of 60 days. Current CMS policy allows for up to180 days, which is often necessary to find housing and necessary supports for an individual to live in the community.

Providers can only be paid for transitional case management services once an individual has successfully transitioned into the community. Unfortunately, due to circumstances well beyond the control of service providers (e.g., the availability of appropriate support services), transition can occur long after the necessary case management services have been provided. Many service providers do not have the financial capacity to wait for reimbursement or to sustain the financial losses if an individual’s transition is not successful.

Status

February, 2005 - The Deficit Reduction Act (DRA) was signed into law. The DRA provided new definitions of case management under the Medicaid program.

December, 2008 – CMS published its interim final rule in response to the DRA which restricts Medicaid reimbursement for case management services. Medicaid experts believe that the interim final rule goes well beyond Congress’ intent in passing the DRA.

The Medicaid case management regulation:*greatly exceeds Congress’ intent when it passed the Deficit Reduction Act.*will put service providers at great financial risk by severely restricting Medicaidreimbursement for critical services.*ultimately harms our most vulnerable citizens – children and adults with disabilities.

I am asking for Representative __________ to cosponsor H.R. 5173, the bill to delay implementation of the Medicaid case management regulation.

3 comments:

Barbara
said...

Hi Arc of NC-- Wonderful stuff. We at The Coordinating Center in Maryland are working very hard to get people on board with supporting the Moratorium. I feel as though we are beginning to get traction. Have you considered sending this info to all Arcs everywhere? Is someone doing that? If anyone needs some verbiage about this relative to people with complex medical needs and disabilities I would be happy to share. bmccord@coordinatingcenter.org please refer them to me

Hi Barbara,This action alert came out from The Arc of the US. It was sent to all of the state Arc offices. In North Carolina we sent it out also to our chapters, board members and e-alert members. This has been a big topic in our advocacy community. I would love to have any verbiage that you are willing to share. We will be collecting stories as we continue to discuss this issue with our state leaders.

Facebook Badge

Power of the Disability Vote!

The Arc of North Carolina 2011 Legislative Agenda.

The Arc of North Carolina advocates for and with families and people with cognitive and developmental disabilities. We believe that the following legislative agenda promotes our goals of advocacy, inclusion, and access to the communities we live in.

The Arc of North Carolina Proposed Policy Agenda 2011

Budget:

The Arc of North Carolina understands the current budget constraints that the state of North Carolina finds itself in due to the economic recession. During this critical time it is more important than ever to protect needed services for people with developmental and intellectual disabilities.We encourage the members of the General Assembly to do the following things to protect the integrity of community-based services for people with developmental and intellectual disabilities in our state.

No additional cuts to state-funded services for people with developmental disabilities.

Apply for 1915 (i) State Plan services for adults with developmental disabilities targeting supports that currently utilize state general fund appropriations and utilizing those funds a Medicaid match.

Add an additional CAP-DD Waiver for people with developmental disabilities who have significant behavioral and or medical needs.

Raise the Supports Waiver limit to 25 thousand dollars.

Utilize the Supports Intensity Scale as an initial eligibility tool for entrance into the CAP waivers with a reconsideration process utilizing other information.

Manage all of developmental disability services from a state system utilizing existing local structures where appropriate.

Housing:Fair Housing Act Amendment.

This legislation prohibits discrimination on the basis or receipt of housing assistance. Many people with disabilities receive housing assistance. This legislation if passed would assist in opening more housing opportunities to the disability community.

Education:Study ways to allow students with developmental disabilities to access current courses in our community college system. Included in this study we must look at ways to offer real job skill training to students with developmental and intellectual disabilities.

The Arc of North Carolina

Welcome to The Arc of North Carolina's official policy blog. The Arc has been serving people with disabilities for more than 50 years. In an effort to reach out to our statewide community about issues that effect us we have established this blog.

Become A Member of The Arc of North Carolina:We encourage you to become a member of The Arc of North Carolina. You can find out more about becoming a member by visiting http://www.arcnc.org/.

Visit Our Facebook Page

Join the debate. Have something to say and want quick feedback? Want to join the social networking craze? We invite you to visit and become a fan of our Facebook Page.

Contact Your North Carolina State Legislators!

Contact Congress!

About Me

Content Disclaimer

Opinions expressed on this blog are not necessarily the opinion of the The Arc of North Carolina or The Arc of the United States.The Arc of North Carolina is a non-profit and non-partisan organization. It does not endorse candidates or political parties.